Endocrine Abstracts

Background: The move from paediatric to adult services comes at a time in a young person’s life when they face multiple life challenges alongside managing their diabetes. Despite our NHS trust having a planned and integrated diabetes transition service, as per NICE (2016) and NHS England (2016) recommendations, we noticed a rise in patient’s not attending clinic and suboptimal glycaemic control.

Aim: To review the data on clinic appointments attended, DNA rates, HbA1c and any hospital admissions in our transition age group from 15 to 21 years old.

Method: We reviewed data on all patients who attended transition clinics at our University Hospital between 2011 and 2019. We categorised the age ranges to 15-17 years, 17-19 years and 19-21 years old. We calculated mean HbA1c values, patient’s clinic attendances, did not attend rates and admissions in these age ranges.

Results: We had 38 patients with appointments in all three age ranges. The clinic appointments not attended was 2.8% for 15–17-year-olds, 12.9% for 17-19-year-olds and 25.8% for 19-21-year-olds, with significantly more missed in both older age groups compared to the 15-17-year-old group (P<0.05). The mean HbA1c increased with each ascending age range, with a significant rise between 15-17 years and 19-21 years (75.7 Vs 80.7, P<0.05). Admission rates increased from ten admissions in the 15-17-year-olds to sixteen in the 19-21-year-olds, although the total number of patients contributing to these values increased from six to twelve patients and a higher proportion was due to DKA in the 19-21-year-olds (15-17 years 30% Vs 19-21 years 62.5%).

Conclusion: We have seen an increase in patients not attending clinics through our transition service. Our data demonstrates that our young people are vulnerable heading into adult services, with significantly higher HbA1c values and increasing admission rates, which could have potentially life-threatening consequence. Although we have an integrated transition service, we are not addressing all outcomes (NICE, 2016) with a lack of psychological support after 16 years old and the need to provide social support for our patients and families which a youth worker could address.